At present, the antitoxic titer of scarlet fever antistreptococcus serums is determined by the blanching of the rash in scarlet fever patients, following the intracutaneous injection of serum, as developed first by Dochez1 and later also by Blake and Trask,2 or by the reactions induced in susceptible persons by mixtures of toxin and serum injected intracutaneously, as developed by the Dicks.3 Attempts to devise a satisfactory in vitro method have not been successful.
While the tests on human subjects have been essential in establishing definite standards for measuring the antitoxic value of the serums, they are proving impracticable as routine procedures for standardization. Toxin-antitoxin tests on normal persons are impracticable for the following reasons: the difficulty of securing subjects susceptible to the toxin but not hypersensitive to horse serum; the objection to the repeated injection of foreign serum; the large number of injections that should be made
WADSWORTH AB, KIRKBRIDE MB, WHEELER MW. STANDARDIZATION OF SCARLET FEVER ANTISTREPTOCOCCUS SERUMS. JAMA. 1926;87(9):623–625. doi:10.1001/jama.1926.02680090001001
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